drug restrictions

Apr 2, 2009

I recently changed jobs and consequently have new insurance. I was unpleasantly surprised that my new insurer had restrictions on the dosage and quantity of particular medications that they would cover. And drugs which I have taken routinely for years to prevent potential shingles outbreaks and for arthritis are not considered "maintenance" medications by my new insurance. The insurance has requested my doctor complete an authorization form. Even after doing this they may not cover the dosages I need. Do I have any recourse to force the insurance to cover medications which I need and allow my doctor to do his job??

Response from Ms. Franzoi

A health plan can have restrictions like this. Even Medicare Part D has some restrictions on medications.

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